| Autor: |
Gianluigi Li Bassi, Raquel Guillamat Prats, Antonio Artigas, Eli Aguilera Xiol, Joan-Daniel Marti, Otavio T. Ranzani, Montserrat Rigol, Laia Fernandez, Andrea Meli, Denise Battaglini, Nestor Luque, Miguel Ferrer, Ignacio Martin-Loeches, Pedro Póvoa, Davide Chiumello, Paolo Pelosi, Antoni Torres |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Intensive Care Medicine Experimental, Vol 6, Iss 1, Pp 1-15 (2018) |
| Druh dokumentu: |
article |
| ISSN: |
2197-425X |
| DOI: |
10.1186/s40635-018-0206-1 |
| Popis: |
Abstract Background We previously evaluated the efficacy of a ventilatory strategy to achieve expiratory flow bias and positive end-expiratory pressure (EFB + PEEP) or the Trendelenburg position (TP) for the prevention of ventilator-associated pneumonia (VAP). These preventive measures were aimed at improving mucus clearance and reducing pulmonary aspiration of bacteria-laden oropharyngeal secretions. This secondary analysis is aimed at evaluating the effects of aforementioned interventions on systemic inflammation and to substantiate the value of clinical parameters and cytokines in the diagnosis of VAP. Methods Twenty female pigs were randomized to be positioned in the semirecumbent/prone position, and ventilated with duty cycle 0.33 and without PEEP (control); positioned as in the control group, PEEP 5 cmH2O, and duty cycle to achieve expiratory flow bias (EFB+PEEP); ventilated as in the control group, but in the Trendelenburg position (Trendelenburg). Following randomization, P. aeruginosa was instilled into the oropharynx. Systemic cytokines and tracheal secretions P. aeruginosa concentration were quantified every 24h. Lung biopsies were collected for microbiological confirmation of VAP. Results In the control, EFB + PEEP, and Trendelenburg groups, lung tissue Pseudomonas aeruginosa concentration was 2.4 ± 1.5, 1.9 ± 2.1, and 0.3 ± 0.6 log cfu/mL, respectively (p = 0.020). Whereas, it was 2.4 ± 1.9 and 0.6 ± 0.9 log cfu/mL in animals with or without VAP (p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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